Medical Drug Edits API
Eliminate errors. Accelerate claims. Optimize operations.
The U.S. pharmaceutical landscape is notoriously complex, with billing and coding challenges that lead to costly errors, wasted administrative time, and frustration for providers and payers alike. MMIT’s Medical Drug Edits API changes that.
Our automation solution ensures claims are accurate, timely, and efficient, reducing delays while protecting revenue. With seamless API integration, you can instantly access MMIT’s trusted, always up-to-date drug pricing and reimbursement data directly within your existing systems.
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Accuracy
Automatically update Facets notes with pricing and claim details.
Efficiency
Route claims seamlessly for manual review or processing.
Reliability
Connect with key data sources including Reimbursementcodes.com, the NDC Database, Carelon, PPA, and specialty documents.
Scalability
Easily adapt the API to handle growing claim volumes and evolving reimbursement rules without adding manual workload.
Keep Up-to-Date with Key Insights From MMIT
Medical Drug Lists Brochure
Medical Drug Lists combines MMIT’s industry-leading pharmacy benefit management tool for payers with RJ Health’s deep domain experience in the medical benefit arena.
MMIT’s ReimbursementCodes APIs Speed Claim Review and Reduce Overpayments
In this case study, learn how one plan saved at least $250K each year by moving to an automated, scalable claims review process.
Solutions to Support Your Strategy
RC Claim Assist
Navigator is the leading formulary management and publishing solution, enabling pharmacy teams to manage how drugs are covered and communicate that coverage clearly to providers and patients.
Medical Drug Lists
We provide an intuitive workflow application that enables health plans to manage and publish medical drug lists so providers can administer therapies and treatments with full transparency, minimizing claim denials and HCPCS to NDC conversion errors.
ReimbursementCodes
Streamline claims workflows with our industry-leading data and workflow applications for medical coding, pricing, and reimbursement.